You finish a hard workout, have a shower, then peer in the medicine cabinet to consider your options: Ibuprofen? Aspirin? Paracetemol? Maybe you just down two pills without a second thought.
It’s hard to pinpoint what percentage of runners regularly take non-steroidal anti-inflammatory drugs, or NSAIDs, the technical term for many types of over-the-counter painkillers (though Paracetemol is not considered to be one), but in 2006, David Nieman of the Human Performance Lab at Appalachian State University in the US, found 70 per cent of Western States 100-Mile Endurance Run participants took a painkiller before the event.
But you don’t have to be an ultra runner to want to numb a creaky knee. ‘The usage we see in competitive athletes trickles down to recreational athletes,’ says Dr Bill McCarberg, founder of the Chronic Pain Management Program at Kaiser Permanente in San Diego, California. ‘People assume they’re safe because they’re sold over the counter, but pain relievers, particularly NSAIDs, can be risky.’
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Runners who pop NSAIDs before a distance event hoping to boost their pain tolerance are making a big mistake, says Nieman. In another study, he gave ibuprofen (600mg and 1,200mg the day before and during the race, respectively) to one group of athletes and compared their performances with a group that took no drugs. There was no statistical difference between the groups’ race times, muscle damage, perceived effort or reported soreness. But some members of the medicated group did have one big consequence. ‘The ibuprofen disrupted the integrity of the cells lining the colon; there was a leakage of bacteria into the bloodstream,’ he says. This can cause a condition called endotoxemia, which can lead to septic shock in extreme cases. The issue runners are more likely to experience is amplified inflammation and oxidative stress (the breakdown of cells), which can increase soreness and delay recovery. ‘Ibuprofen can make things worse,’ says Nieman.
There are various reasons to suck it up and skip the drugs altogether. First off, it can help you recover better: During exercise, small tears occur in your muscles, triggering white blood cells to rush in and start rebuilding. If you take an anti-inflammatory, you may interfere with that recovery process. Pain also tells you when it’s time to take a rest day - popping a couple of pills and going out for a run with a sore foot or knee is a good way to end up with a serious injury. Finally, a 2009 study found that anti-inflammatory drugs inhibited antibody production. Hard training can suppress immunity, so adding an NSAID to the mix may make you more likely to become ill.
But, taken sensibly, these meds do help runners manage aches and pains. See below for how to do that – safely
